A Conversation With ... Charlotte Horsman

What is your role in helping employees get the most out of their benefits?
An advocate, an advisor, somebody who looks out for their interests and helps them to navigate their choice with regard to the carriers that are available in the marketplace. Basically, what I do is, I search and bring back ideas and plans for them to consider and educate them.

As an independent insurance agency, PJC represents all of the market available for life, health and related lines of coverage. Today, we have approximately 13 fully insured carriers. Our agency also markets self-funding as an alternative model, and there are multiple resources to help an employer.
 
How would you characterize the insurance market right now?
It’s uncertain, but we will know more in a couple of weeks with the pending election. It will give us a real indicator if we are going to be moving forward with health care reform as we know it to be today or if we will redirect some of those efforts and see new discussions back at the drawing board if there is a change in administration. We have exhausted a lot of time and energy in being very in touch with what has taken place and to help educate and inform our clients. The poor employers in our community they just don’t know what to think; they are not sure what is going to happen, and we are that front-line person to bring that understanding to them and help advise them on what path they need to take and how to go about it.

Tell me about premium changes employees and businesses can expect in 2013.
(Businesses) can expect more regulation right now. For 2013, everybody is continuing to prepare for 2014, so they are still purchasing their insurance through the private market that we all know.

Health care reform promised to reduce premiums by $2,500. The reports I’m hearing indicate the rates under the current administration’s bill went up $2,500, and if we move forward as required in 2014, they will continue to rise. I have seen everything from a 1 percent decrease to a 40 percent increase. The overall cost continues to trend upward to an uncomfortable and intolerable level for the employer.

What question do you get most often regarding benefits?
Today’s most popular question from the employers is: What am I going to do with health care reform? The employer is really leaning on the agent to gain some understanding because they are concerned about compliance. They simply can’t effectively manage their business and manage becoming an expert in how to stay compliant at the same time. The regulation is making the process much more complex, and that’s going to continue in 2014.

The other main factor is cost. People don’t know how to get it under control. It’s not a simple solution.

With economic pressures, are companies cutting coverage for cost savings? How do they strike a balance?
We are seeing a lot of more shared contribution on the part of the employee to manage the costs. I’ve got employers that are reducing the benefit to kind of manage the cost that way. They are reducing their contribution levels, reducing the benefit itself. Then others are more drastically teetering on removing the plan altogether. As a rule, an employer wants to be able to provide their employees benefits, but it becomes a hard-pressed position they find themselves in when they realistically can’t manage that cost any longer. We are not seeing the employers able to just give the benefit without any contribution from the employee; they have to pass along some kind of cost.

However, there are other solutions they can pursue, such as the funding mechanism and the style of the plan. In other words, people purchase health savings account-type plans to reduce the cost, which are designed differently then preferred provider organization-type plans, where we have co-pays to go to the doctor and get our medicine. Those are options they are using and ways they are approaching it to try and manage that cost. Others are influencing their situation by considering wellness to manage the costs from the prevention standpoint.[[In-content Ad]]